| Identifier |
walsh_2015_s1_c3-1 |
| Title |
Speakeasy |
| Creator |
Joseph G. Chacko; Marcus Moody; Harry H. Brown; Sarkis Nazarian |
| Affiliation |
University of Arkansas for Medical Sciences Little Rock, AR |
| Subject |
Cavernous Sinus Tumor, Perineural Invasion, Adenoid Cystic Carcinoma |
| History |
A 64 year-old Caucasian gentleman presented with an unusual complaint. He stated that if he touched the inside of his right cheek with his tongue, he felt a tingly sensation in his R eyebrow. This had started one month ago. He also complained of foreign body sensation and discomfort in the right eye for six months. Additionally, he had recently noted a droopy R eyelid for which his local ophthalmologist had placed a stitch in his R upper lid to lift it. He also complained of recent binocular diagonal double vision. Past medical history included hypertension, hyperlipidemia, emphysema, and coronary artery disease requiring 4 stents (2002 and 2011). Social history was significant for 50 pack-years of smoking, and he drank 6 beers per week. His medication list included simvastatin, prasugrel, fluticasonesalmeterol, tiotropium bromide, aspirin, metoprolol, and hydrochlorothiazide. Exam revealed bestcorrected visual acuity of 20/40 and 20/25. BP was 125/70. Pupils were 5.5 mm and 5 mm, with no RAPD. IOP was 19 and 21. Eye movements revealed -1 adduction, -3 supraduction, and -1 abduction in the R eye only. Visual fields were full to confrontation OU. External exam revealed ptosis with an MRD of -2 OD and +2 OS. Facial sensation to cotton tip was WNL bilaterally. Slit lamp revealed a decreased tear film OD and mild corneal scarring OD. There were 2+ nuclear sclerotic cataracts OU. Dilated fundus exam revealed pink, sharp optic discs with normal cups and spontaneous venous pulsation OS. A diagnostic procedure was then performed. |
| Disease/Diagnosis |
Adenoid cystic carcinoma of right pterygopalatine fossa with perineural spread to the cavernous sinus |
| Date |
2015-02 |
| References |
1. Huang, Lee. Adenoid cystic carcinoma (ACC) of the sinonasal tract with perineural spread into the cavernous sinus. Arch Otolaryngol Head Neck Surg.134(9):1009-1011, 2008. 2. Arsene, Ardeleanu, Dănăilă. Skull base tumor invading both cavernous sinuses. Adenoid cystic carcinoma mimicking a meningioma. Rom J Morphol Embryol; 47(4):367-71, 2006. 3. Ginsberg, Demonte. Palatal adenoid cystic carcinoma presenting as perineural spread to the cavernous sinus. Skull Base Surg; 8(1):39-43, 1998. 4. Adachi, Yoshida, Ueda, Kawase. Adenoid cystic carcinoma of the cavernous region. Neurol Med Chir (Tokyo);46(7):358- 60, 2006. 5. Tse, Benedetto, Morcos, Johnson, Weed, Dubovy. An atypical presentation of adenoid cystic carcinoma of the lacrimal gland. Am J Ophthalmol;141(1):187-9, 2006. |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Source |
47th Annual Frank Walsh Society Meeting |
| Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2015 |
| Collection |
Neuro-Ophthalmology Virtual Education Library - Walsh Session Annual Meeting Archives https://novel.utah.edu/Walsh/index3.html |
| Publisher |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-6247 |
| Rights Management |
Copyright 2015. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6n61hzm |
| Setname |
ehsl_novel_fbw |
| ID |
179270 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6n61hzm |
